[Realities and perspectives of stroke prevention in atrial fibrillation: physician's opinions analysis]

Kardiologiia. 2013;53(10):30-6.
[Article in Russian]

Abstract

The purpose is to study the opinions of general practitioners and cardiologists on the issue of stroke prevention and the prospects of new oral anticoagulants treatment of patients with atrial fibrillation (AF). 240 physicians, of whom 139 were general practitioners and 101 cardiologists, were questioned. The physicians awareness of stroke as the most dangerous AF complication was 84.6%. Only 39.2% of respondents assess the risk of stroke by CHADS2 or CHA2DS2-VASc scores. 24.2% of respondents express their willingness to assign the oral anticoagulants in case of the stroke risk value of one point of the scale, 61.7%--of two points. 40.4% of physicians will prescribe the oral anticoagulants to AF patient older than 75 years. At the same time acetylsalicylic acid is prescribed unreasonably often to AF patients with stroke risk. 85.0% of respondents believe the complexity of controlling and instability of the international normalized ratio to be the barrier to warfarin prescription. We revealed the differences in the approaches to antithrombotic drugs choice between general practitioners and cardiologists, as well as between subgroups of doctors who use or don't use the stroke risk scale. The majority (64.2%) of respondents are found to be aware of the mechanism of action of new oral anticoagulants (dabigatran etexilate). The arguments for their wide use most often indicated are simplicity of application (78.8%), higher safety (53.8%) and efficacy (29.2%) as compared to warfarin. The analysis of doctors' opinions about the possible effect of financial reasons on the frequency of prescribing new oral anticoagulants was also carried out.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Administration, Oral
  • Adult
  • Atrial Fibrillation / complications*
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Risk Factors
  • Stroke / etiology
  • Stroke / prevention & control*
  • Surveys and Questionnaires*

Substances

  • Fibrinolytic Agents